Breath Test for Lung Cancer Screening Under Evaluation in Pilot Study

A team of researchers is investigating whether hydrogen peroxide in exhaled breath condensate is a potential biomarker for lung cancer and validating a tool to measure it, according to a presentation at the American Thoracic Society 2025 International Meeting.

Daniel Santone, MD, of Indiana University, and colleagues, conducted the study and presented their findings. The researchers explained that although lung cancer screening with low-dose CT scans has “proven to be an effective method for early detection and reducing cancer-related deaths,” there is a “lack of personalization in screening and risk calculators.”

However, Dr. Santone and colleagues explained that earlier studies have shown that hydrogen peroxide is elevated in the exhaled breath condensates of patients with lung cancer, which is in line with the elevated hydrogen peroxide levels found in exhaled breath condensates of patients with infections and inflammatory pulmonary diseases.

The researchers are conducting the pilot study to evaluate the role of hydrogen peroxide as a biomarker for lung cancer and compare its levels in patients with COPD, which is a “common comorbidity” in patients with lung cancer. They plan to measure the levels of hydrogen peroxide in exhaled breath condensates using Inflammacheck, “a validated point-of-care device.”

The study investigators plan to evaluate three patient groups:

• People older than 40 years with no lung diseases
• Patients with COPD who do not have cancer
• Patients with lung cancer before treatment initiation

Patients with recent pneumonia, COPD exacerbations, autoimmune diseases, or a history of cancer within the last 5 years will be excluded from the study. The researchers also plan to gather data on demographics, peripheral eosinophils, pulmonary function test results, TNM staging, and imaging data. Dr. Santone and colleagues explained that they aim to recruit a total of 60 participants, with 20 in each group. To date, the study has recruited 10 participants and has confirmed that hydrogen peroxide can be measured in the exhaled breath condensates of people with and without lung cancer, with preliminary analysis indicating that the “levels are higher in lung cancer patients compared to healthy controls without any lung diseases.”

At the end of the study, the investigators will use a two-way analysis of variance (ANOVA) to “analyze the differences between the three groups and potential interactions with other covariates,” they explained. The study will provide information that can help determine whether hydrogen peroxide measurement in exhaled breath condensates is “a valid tool for personalizing lung cancer detection and will set the groundwork for future research focused on using it as a screening tool.”

Reference

American Thoracic Society 2025 International Conference. Poster Board No. P797.